Category Archives: Critique of Aid

Critique of Aid, Politics

Refugees and Migrants: A New (old) Narrative

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Imagine the scene. A desperate mass of stricken, exhausted, frightened people find refuge. Perhaps for the first time in years, they sleep with two eyes shut. Bam! A powerful group wrenches the money, jewels and property from their hands. Highway pillagers? Blood-thirsty criminal gang? Friends of Joseph Kony? Nope, nope, nope. That’s the work of the Government of Denmark and the Government of Switzerland (see e.g., here). In other words, it is the cunning policy of governments obligated by law to protect these very people. Governments, I might add, one does not usually associate with regime thuggery. This doesn’t pass the smell test.

In a related example of erecting clever barriers because a wall seems too crude, Obama’s US government will set up screening centers in Latin America, to “head off migrants . . . before they start traveling to the United States.” And who will be implementing these barriers screening centers? No, not Donald Trump. It’s UNHCR, the UN agency dedicated to defending refugees and the right to seek asylum.

Denmark? Switzerland? Obama? UNHCR? With friends like these … And lest the humanitarian community feel superior, let us remember that the appeals for money to fund programs in Syria have been unmistakably louder than appeals for Western governments to open their doors. A logic reminiscent of George Bush has evolved: if you help us feed/clothe them over there, they won’t come over here.

As Sara Pantuliano and others have astutely argued, it is time to change the narrative. Rather than view migrants as risks (or, for that matter, leeches, criminals and terrorists), she elaborates, the debate needs to be reframed to recognize “the substantial social and economic contribution they can make to their host societies.” Certainly, a more balanced understanding of migrants and refugees is necessary. But will a more accurate, positive spin on the situation work?

I have my doubts. Once a public debate is permeated by fear, once politicians seize upon those fears to gain power, once a gaping us-them divide blocks humanizing discourses . . . Well, let’s just say it becomes extremely difficult to engage in the sort of discussion where facts possess the power of persuasion. Look at the gun control debate in the US, or the past decade of immigration debates that have cropped up in much of Europe.  People become fact-resistant, positions entrenched, opinions shouted at the other side. In the situation we have today, facts don’t matter as much as we would like to believe.

More importantly, arguing the facts, arguing the other side of the coin, does not reframe the debate, it reinforces it. By accepting those terms for the discussion – the pros and cons of refugees – one undercuts the idea that asylum and refugee decisions should be based on principles, on the law, on an ethic of compassion. To reframe the debate, we need to discuss what is right and what is human, regardless the consequences. We need to avoid the a policy discourse of self-interest: asylum cannot depend on whether or not the safe haven needs you. Is Germany’s open door a more moral approach than other nations? Or a more enlightened understanding of domestic needs and migrant potential? I hope the former, I fear the latter.

If we want to salvage the sinking ship formerly known as the right to seek asylum, if we want to defend the 21 million refugees in the world, facts may be useful, but principles must be foremost. Not because loudly proclaiming what is right will win the argument, but because it is the argument most worthy of losing.

Critique of Aid, Health

Ebola: Lessons not learned

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[Thanks to Aid Leap for publishing this on their website. Check it out here, along with lots of excellent thinking on aid.]

Tomorrow will mark 42 days since the last new case of Ebola in Sierra Leone, meaning the country will join Liberia in being declared Ebola-free. That brings the world one step closer to a victory over Ebola the killer.

But Ebola has another identity – messenger. We listened. It told us that many aspects of the international aid system are not fit for purpose. Many – too many – of the problems the outbreak revealed are depressingly familiar to us.

Pre-Ebola health systems in Sierra Leone, Guinea and Liberia were quickly overwhelmed and lacked even basic capacity to cope with the outbreak. The World Health Organisation (WHO) failed to recognise the epidemic and lead the response, and international action was late. Early messaging around the disease was ineffective and counterproductive. There was a profound lack of community engagement, particularly early on. Trained personnel were scarce, humanitarian logistics capacity was insufficient and UN coordination and leadership were poor.

The lessons learned should also come as no surprise: rebuild health systems and invest in a ‘Marshall Plan’ for development; make the WHO a truly robust transnational health agency and improve early warning systems; release funds earlier and make contracts more flexible; highlight what communities can do, and engage with them earlier. Except these lessons learned haven’t really been learned at all: they are lessonsidentified repeatedly over the past decades, but not learned. 

Why is the system almost perfectly impervious to certain lessons despite everyone’s good intentions? The short answer: these lessons are too simplistic. They pretend that the problem is an oversight, a mistake to be corrected, when in fact the system is working as it is ‘designed’ to work.  The long answer: what is it about the politics, architecture and culture driving the aid system that stops these lessons from becoming reality?

Take a simple idea, like reconstituting the WHO as an intragovernmental agency with a robust mandate to safeguard global public health, and the power to stop an outbreak like Ebola. Sounds great, but not new. So it also sounds like wishful thinking. It does not address the inherent tension between sovereignty and transnational institutions.

Think of it this way: the more robust an institution, the more of a threat it poses to the individual states that are its members, and hence the greater incentive for those states to set limits to its power. WHO was ‘designed’ not to ruffle feathers.

A robust WHO? Can you imagine the WHO ordering the US or UK governments to end counterproductive measures such as quarantining returned Ebola health workers or banning airline flights to stricken countries? It will never happen.

Here is the true lesson to be learned: at a time of public fear and insecurity, it would be political suicide for any government to allow such external interference. The problem isn’t the institution, it only looks like it is; the problem is the governments that comprise it. That is not to say that WHO cannot and should not be improved. It is to say that the solution proposed cannot address the fundamental problem.

Or take a complex idea, such as community engagement. Our Ebola research found that the ‘early stages of the surge did not prioritise such engagement or capitalise on affected communities as a resource’, a serious omission that ultimately contributed to the spread of the disease, and hence a key lesson learned (see e.g., this Oxfam article).

Disturbingly, this is a lesson with a long history. Here, for example, is what the Inter-Agency Standing Committee (IASC) found in evaluating the international response to the 2010 earthquake in Haiti. The relevance, virtually word for word, to the situation in West Africa speaks for itself:

The international humanitarian community – with the exception of the organisations already established in Haiti for some time – did not adequately engage with national organizations, civil society, and local authorities. These critically-important partners were therefore not included in strategizing on the response operation, and international actors could not benefit from their extensive capacities, local knowledge, and cultural understanding … This is not a new observation. Exclusion of parts of the population in one way or another from relief activities is mentioned in numerous reports and evaluations.

Why is this lesson so often repeated and so often not learned? Does the answer lie in an aid culture where ‘taking the time to stop and think – to comprehend via dialogue, engagement and sociological research – runs counter to the humanitarian impulse to act’? Our report also discusses a greater concern: the degree to which people in West Africa were treated ‘as a problem – a security risk, culture-bound, unscientific – to be overcome’. 

The ‘oversight’ is hardly an oversight: people in stricken communities ‘were stereotyped as irrational, fearful, violent and primitive; too ignorant to change; victims of their own culture, in need of saving by outsiders’. Perhaps that clash of cultures highlights why we should not expect community engagement to spontaneously break out simply because the problem has been recognised.

Powerful forces work against aid actors engaging with the community during an emergency, leaving us with a lesson that has not been learned even after years of anguished ‘never again’ promises to do better.

Lessons learned are where our analysis of the power dynamics and culture of the international aid system should begin, not where it ends.

Critique of Aid

Humanitarian Effectiveness (2)

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My previous post on this topic prompted a slight twitter buzz, with Patricia McIlreavy astutely pointing out that the aid ‘oligarchy’ isn’t just the big INGOs, but donors and the UN as well.  Dead right on that one.  They all employ wield effectiveness in an exercise of power.

Effectiveness seems to be part of a powerplay within the oligarchy as well. By way of broad generalization, the question of effectiveness functions as a spotlight, used by people in desk chairs to examine the work of people with mud on their boots.  Sounds good, right?  What about the reverse?  When can Mud-on-Boots cast the same light on the work of Deskchair? More importantly, why doesn’t the functioning of the aid system drive Deskchairs to cast the same scrutiny on the mountain of Deskchair work in the system?

It should. The aid system comprises immense resources and people – energy and ‘action’ – at the level above the field project.  Having just sat through one, how do we assess the effectiveness of a conference on effectiveness? Better yet, what has been the collective effectiveness of years of debates, research, publications, workshops, tools, guidelines and previous conferences on effectiveness?  In other words, why don’t those of us thinking about effectiveness shine the light on our own work?

At great effort and cost, the aid system produces a spectacular amount of material designed to improve the effectiveness of aid. How does that translate into lives saved, or suffering alleviated? Might it even work as an impediment? I remember a medical coordinator in MSF telling me that in the span of six months in South Sudan she received over 600 recommendations from headquarters.  No doubt lots of good advice, but what is the combined impact on stressed out and under-resourced field teams? Trying to regulate or rationalize this onslaught of advice leads to discord at HQ, with staff feeling disenfranchised from the operational mission. Put differently, each and every one of those 600+ recommendations represented the aspiration and drive of somebody at HQ seeking their ‘fix’ of field involvement, their dose of ‘making a difference’.  That’s not speculation. That was my fix too.

[Spoiler alert. This post should end right here. The next bit is a real downer. I blame the start of a cold, wet final weekend to England’s so-called summer.]

Shining the spotlight of effectiveness on this work can be disconcerting. Much of my considerable HQ product seems rather obviously designed to have allowed me to be part of the crisis response based on a blind faith in its actual impact.  This is a faith requiring permanent contortion, to avoid noticing the ten degrees of removal between my efforts in London and saving a life in the field.

It looks like this:

Start with a new / improved [fill in the blank: protocols/tools/reports/guidelines/strategies/etc].

  1. Did overworked field teams even read it?
  2. If they read it, did it change practice?
  3. If it changed practice, was it in a positive direction? Was the new thing better than the old thing? No shortage of examples where idealized efforts at improvement collided with reality on the ground.
  4. If it changed in a positive direction, by how much? In other words, did the impact actually save lives and alleviate suffering more effectively? Remember, much of aid work is pretty damned good from a technical perspective – improvement runs into the law of diminishing returns.
  5. If it had a positive impact, did that outweigh the cost/effort/resources that went into producing the improvement? How many meetings and emails!
  6. If it had a positive impact, did it last? Or: did it calcify into a tick-box exercise? Or: did new teams = old ways?

That, believe it or not, is only the first level of analysis.  If it stopped there, the verdict on effectiveness might often come out OK.  The key here is # 5. Here is what the process does not look like: a couple of smart Deskchairs put their heads together, come up with a new [fill in the blank: protocols/tools/reports/guidelines/strategies/etc], show it to their boss, make a few changes and ship it out to the field.

It looks more like this: a couple of smart Deskchairs put their heads together, come up with a new [fill in the blank: protocols/tools/reports/guidelines/strategies/etc] dealing with X, which then unleashes a frenzy of effort to take the good thing and make it very good.  Within the various branches of the organization, there will be ten, maybe twenty or maybe a hundred who have made a heavy investment in X.  Each will need to comment on the new thing. Many comments will replicate each other, others will contradict. Skirmishes will ensue – “communities” vs. “people” in paragraph 7, roll out in August (rain season!) vs November (too late!!!!), and so many more. Complaints will move up the food chain – Why weren’t we involved sooner? You need our approval! Meetings will be held and hair will turn gray. The thing will launch. Now start at Step 1.

And on it goes.  I have been involved in many of these processes. Even the ones avoiding the quicksand of organizational politics involved multiple, duplicative commitments of effort.  More to the point, they involved faith that improvements – objectives phrased more clearly, the addition of a resource annex, newer research included – actually mattered in some way. How could they matter? How could a rephrased set of objectives save lives and alleviate suffering? Faith is beautiful that way.  Proof is not required. A collective investment in the possibility that what we do matters.  The spotlight of effectiveness is unwanted here.  And so is it rarely shined.

Critique of Aid, Our Western Identity

The Problem with Effectiveness (1)

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My first blog sent from the city of Manchester, arguably the birthplace of modern Capitalism: “there are good reasons why those in the Southern Hemisphere view [the big NGOs] as the ‘mendicant orders of Empire’” (Michael Barnett in The International Humanitarian Order). So an appropriate location for an HCRI-Save conference on humanitarian effectiveness.

What is effectiveness? As with many concepts, the further one dissects it, the more wooly it becomes. So a nice generator of the sort of navel-gazing exercises that I find so stimulating and that consume a lot of humanitarian energy.  That said, the discourse of effectiveness warrants being unpacked from a number of angles, especially within a political economy of aid. On that, two initial reflections.

First, the ‘oligarchy’ of global western humanitarian NGOs uses the language of effectiveness to defend its turf, funding and power.  Argument to donors: give us the money, because we are more effective than them.  Here, ‘them’ refers to emerging NGOs from the global south, who are almost by definition going to come up short in terms of effectiveness. After all, it is the oligarchy’s definition of effectiveness in the first place, and the oligarchy has enormous advantages in terms of resources, experience, infrastructure, etc.

Second, the discourse of effectiveness sidesteps ethical issues.  As somebody pointed out in one of the sessions, what is effective and what is right are two different questions.  Those arguing for the supremacy of effectiveness miss the problematic reality of an aid industry that is often ineffective and unaccountable.  Let’s be clear, aid is a tough business, and we should expect that it often falls short of being effective, no different than welfare programs in our home countries, which have regularly failed in efforts to lift the poor out of ghettos, improve public health or reduce drug abuse (for example).  That is the nature of the work.

But there is a fundamental difference. There is something regrettable about our ineffective efforts to do good in our backyard and for ourselves.  But there is something regrettable and unethical with our ineffective efforts to do good in their backyard, with their lives at stake, and yet where they have neither say over how it unfolds nor recourse when it does not go well.

Critique of Aid

Called Out

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Story 1. The Daily Mail’s recent investigation revealed that charity fundraising agents employ aggressive techniques, harassing everyone, even people with dementia in order to score a donation. The DM trumpets a revolting story of how one lovely old woman, 92-year-old Olivia Cooke, was killed by cold calling.

Story 2. All these charities have ‘robust’ measures in place, none of these charities ‘tolerate’ unethical call practices, all these charities have elaborate systems to ensure their telephone fundraising agents comply with the ‘highest standards’ of practice, none of them knew what was going on, all of them are ‘outraged’ and will get to the bottom of this… (see here, for example)

Point 1: Something does not quite add up.

Question 1: Which conclusion is worse? That charities all know exactly how cold-call fundraising campaigns function, and yet make a calculated compromise? That it is largely the charities who dictate a game in which call agencies must deliver the greatest bang for the buck – an equation doomed to sideline ethical concerns? Or that nobody knew the path that was being taken in their names (conveniently, in that case, all we need to do is change paths by hiring a different agency)?

Answer 1: No answer to those questions gets rid of the queasy feeling that more of the public now thinks of us in terms usually reserved for celebrities who get caught cheating on their spouses.

Point 2.  We are all in this together. Trust is the primary precondition for the aid world.

Story 3: The aftermath has been predictable. Now, the industry trots out sincere handwringing, apologies and pledges for investigations/change. Now, announcements to stop using cold call tactics and a new supporter pledge to behave better. Now, the politicians, fundraising industry and aid business have jumped on the bandwagon of salvation.  Tough measures will be taken! Abuse will be stamped out! A new morality will rule the day because it turns out humanitarians – like the politicians and bankers in opposition to whom we routinely define our goodness – need a new morality.

Question 2. The question isn’t whether NGOs should wean themselves from cold calling or establish confidence-building supporter pledges. The question is why supporter promises, a relatively ancient, tried-and-true practice, were not in place long ago. The question is why cold calling is ever used to raise money for humanitarian ends.

Answer 2 (literal version): Decisions were taken not to make a supporter promise.  Decisions were taken to ignore the ethical concerns around cold calling in order to deliver on cash.

Answer 2 (simple version):  We have large headquarters and we have massive needs to fulfill – a globe of human suffering no less –and that costs money.

Answer 2 (complex version): The incentives in a supply-driven aid system emphasize financial bottom lines over operational effectiveness.

Answer 2 (deep version): Across many dimensions of our work, the humanitarian has a vested interest in believing that ends justify means.

Main Point: The Daily Mail – and we should expect as much – almost defines the “shark kills surfer” school of journalism.  Shock sells news.  Little old ladies with Alzheimer’s became the story. So little old ladies become the problem and then drive the solution.  In whipping up the lurid tale of our fallen humanitarian nobility, the media buried the greater imperative. A focus on the extremities of harassment veils the banality of aid’s hard-fought principles being eroded by the business of self-interest.

Story 4:  Where have we heard this saga of disenchantment before? Just about everywhere.

Critique of Aid, Health, Politics

The Product of Systems

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Who is in charge? Part 1.

The richest 1% of the world will soon have a greater share of the world’s wealth than the other 99%. With that eye-catcher of a stat, Oxfam launched a report and a discussion on extreme global inequality. Great stuff. Do not let the quibbling distract you. This is a street child face down on a busy sidewalk in a pool of excrement. Trust your gut: imbalance on this scale is inherently and dramatically wrong. The only debate should be which is worse – what this says about wealth distribution or what this says about power.

But what if I told you that I just read about a place where the richest few control 99.8% of the wealth? Not 48%, as Oxfam’s report denounces, but the whole enchilada? Ninety-nine point eight percent represents an astounding achievement in disparity. Can you guess where? No, not mega-corrupt states like Angola or Equatorial Guinea. No, not the petrol-rich like Qatar or Bahrain. No, not even Mark Zuckerberg’s family. Give up?

The surprise winner of the award for the most inequitable distribution of wealth and control on the planet is none other than us, the ensemble of humanitarian NGOs. Congrats to the likes of MSF and Save and (of course) Oxfam. Here’s Development Initiative’s excellent financial analysis of the humanitarian system (see p. 55ff): National and local NGOs form an essential part of the humanitarian response, but in 2013 only directly received US$49 million – just 0.2% of the total international humanitarian response. That’s US$49M out of about $2.3 billion hitting NGO coffers worldwide.

You can quibble with that figure – it’s not counting indirect flows to national NGOs – but my advice is to trust your gut. Eat your heart out, Donald Trump.

Who is in charge? Part 2

Bill Gates talks solutions. Bill Gates is right. Bill Gates calling for “germ games”. Bill Gates is all over my Twitter feed.

Gates has published an Op-Ed in the New York Times, an article in the New England Medical Journal and done a lot of media work to proclaim that good old human “ingenuity and innovation” can avoid the next Ebola disaster.

Gates makes sense, of course, calling for the development of vaccines, for better surveillance, for a global logistical and medical epidemic response capacity. Gates’ central point, though, is only half correct, and therein lies the flaw in his cunning plan. Gates claims (NYT piece): The problem isn’t so much that the system didn’t work well enough. The problem is that we hardly have a system at all.

Really? Is it that the system doesn’t exist? Or is it that the non-system of epidemic response is the direct product of another system, a highly inequitable international system of interests and power that does not typically place the public good as its paramount ambition? In other words, the very same international system upon whom Gates calls to act.

On one level, Gates forgets what happens to good ideas when their basis for attention and funding is fear and insecurity. What happens when you employ scaremongering to mobilize politicians and Western publics into funding better healthcare systems for the world? My guess: skewed priorities (epidemiological surveillance trumps maternal mortality) and unforeseen consequences, like helping to justify military expansion into global health and humanitarian action. It has not exactly served the lofty goals of international development to have become an integral tool in the global war on terror.

Most importantly, though, Gates seems to be addressing symptoms, not causes. In calling for an international epidemic response system, Gates essentially advocates the same superpower and global institutional approach that helped deliver WHO’s ineffectiveness, Sierra Leone’s woefully inadequate healthcare, or an Ebola response in West Africa that was too late, too slow and too focused on staunching the Westward flow of Ebola rather than healing those who already had it.

Bill Gates outlines a system the world needs to build. Dead right. Now he needs to outline the world that will build it, because he is silent on the need for changes in the way global institutions are conceived, controlled and built in the first place.

Critique of Aid, Politics

The Perils of Blind Faith

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It would be difficult to imagine a person who better combines passion with sanctimony than Bernard Kouchner. He is not self-effacing. Then again, it is his ego and talent that gave birth in part to MSF, and in part to the right to intervene on humanitarian grounds (“droit d’ingerence”), later more or less codified as the Responsibility to Protect (R2P). This entertaining interview on Al Jazeera’s Head to Head program, quite heated in parts, brings out the full Kouchner. He is insufferable and yet also bold, for instance producing an unqualified YES when asked if France should have apologized for its role in the Rwandan genocide. You don’t hear many politicians being as candid.

It’s worth watching just to see the grilling he gets, but also for his unwavering commitment to the idea of humanitarian militarism, of going in to stop the killing. Over and over, Kouchner champions the idea that when people are being killed, doing something is better than doing nothing. His belief seems unshakable, even in the face of examples like the West’s 2011 intervention in Libya, whose humanitarian cloak quickly slipped to reveal an agenda of regime change; an intervention that put Libya on the path to the unqualified violent mess of Libya today and nourished a brutal insurrection in Mali. Humanitarian? More lives lost than saved? Kouchner doesn’t just dodge that question, he seems to view it as irrelevant.

Kouchner accepts no responsibility for the negative outcomes of Western intervention. He deems interfering, even through military means, better than letting people get butchered. Is it good enough, as one of the panelists suggests, to dismiss bad outcomes on the grounds that the intent was pure? That everything else – the messes of the West’s failed state-building in Iraq or Afghanistan – is simply the law of unintended consequences? He seems equally impervious to arguments that the promise of R2P is chimerical, an attractive doctrine that works only in theory because in the real world it has and always will be used to justify self-interested political and military intervention by big powers into the affairs of little powers.

Much of this would be no more than thought-provoking for us humanitarians were it not for the fact of R2P and MSF sharing the same birthplace. Fraternal twins? Once fans of the idea, nowadays most humanitarians I know regard R2P with healthy skepticism. We are quick to recognize the political intent or neo-imperial posturing when the world powers decide to intervene somewhere, especially when based on a humanitarian imperative. And we are quick to note the hypocrisy of so many decisions to look the other way.

Contrast this with our less skeptical approach on calling for more humanitarian aid, as if it were unrelated to the right to interfere politically or militarily. On the level of and connection to power, the similarities of R2P to humanitarian action remain largely invisible to us, despite their sharing (literally, one could argue) the same DNA.

It seems right to me, unshakably right to me, that humans cannot allow other humans to be killed, to die, or to suffer without doing something. Am I as blind as is Kouchner on R2P? Why dismiss military intervention as mistaken given real politik while compassionate aid is necessitated because of real politik? Of course there are negative consequences. They do not shake our faith in the moral imperative to come to the aid of people in crisis; and in the heat of action are easy to ignore or dismiss.

Is it enough to press for more effective anticipation, monitoring and correction of negative consequences: better context analysis, a more piercing focus on the role of aid within the economy of war and openness about mistakes? All good. (Done poorly or half-heartedly, though, these control measures may even serve more to ease our doubts than to correct problems.). What about the deeper level, touching upon the model for humanitarian action, and the web of power relationships in which it rests? We humanitarians possess a profound need to feel good about our work, one that is well-insulated from challenge. What’s hiding in there?

The interview with Kouchner presents a vision of blind belief. For me, it brings these doubts to a head at about the 38 minute mark, leaving me to ponder an exchange between Kouchner and a member of the audience.

Question (from a young Kenyan woman): “…MSF’s actions are often followed by French troops. How would you react when people ask you is MSF just another engine [NGO? The word she uses is unclear] that protects French commercial interests?”

Kouchner: “You are partly right…”.

That is more than a casual sharing of DNA.

Critique of Aid, Health, Our Western Identity, Politics

5 Shots on Ebola

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1. Return of the Jedi

Oh no. Just when there was some good news – falling rates of new Ebola cases in Liberia – the Ghost of Aid Mistakes Past has returned to haunt us. Bob Geldof will launch another Band Aid rendition of “Do They Know its Christmas” (One Direction I can understand, but Elbow? – say it ain’t so).

Thankfully, the response is far from a collective sigh of relief. It is refreshing to see still more cracks in the wall of the West’s narrative on aid and Africa. As I discussed in a previous post, we can now hear the voices of “outsiders” (i.e., people who actually come from places like Liberia or Nigeria instead of people like me): challenging the bias in Ebola media coverage (reinforcing the industrial savior complex); lambasting a 60 Minutes piece that treated Liberians strictly as background props; or questioning the methods/intentions of Geldof and company.

Really, African stars should gather and launch a campaign “Do They Know its a Continent?”

That said, even this critique presumes that the 1984 version of Band Aid constituted some sort of historic success. Trashing Sir Bob for promoting an antiquated vision of Africans as helpless victims misses the tragedy of Ethiopia 1984. People were dying less from drought than from the government’s human rights violations (as concluded by Human Rights Watch). In that perverse environment, aid distributions propelled the forced relocation policies that were destroying whole communities, not to mention the more recent and controversial revelation that famine relief funds helped buy arms for rebel secessionists. (See here for David Rieff’s cogent view).

2. Useful Enemies

The outbreak of fear and hysteria in America is neither funny nor accidental. Amplified by the sheer power and influence of the US, the rest of the world should take note. Nobody is safe on the same planet as a drunken giant.

The USA’s partisan cockfighting means a disease such as Ebola cannot be tackled according to sane public policy. That is because for too many leaders, the usefulness of the virus outweighs its risk. In this case, Republicans have seized the opportunity to produce a state of froth, portraying Obama and the Democrats as soft on defense, with Ebola taking the place occupied only a few months ago by ISIS. Watch here as Roosevelt perfectly hit this nail on the head 80 years ago.

If there are ever significant numbers of Ebola cases in the US, this sort of panic, media hype and political dysfunction will have a good chance of driving the disease underground, shutting school systems, fomenting violence, etc. In other words, of causing the shit to hit the fan. That’s what I would call a frightening dry run for airborne avian flu. And in certain cases, that’s what makes American hysteria a risk factor for global outbreak and collateral economic damage.

3. Two-Thirds

Tuesday I took a break from my break and sat in on a roundtable discussion of the crisis. Twenty-five or so aid workers, government officials, academics from around London. Heaps of good analysis. Lots of experience and first hand knowledge of the situation in Liberia and Sierra Leone. And I’m not sure the entire group could have put together one solid paragraph on French-speaking Guinea. Whatever the bias – language, colonial heritage, aid policy – it marks a structural weakness in the international community.

4. Fear as Policy

Obama has sounded relatively reasonable on the Ebola front. Here’s the Prez hugging medical staff who caught Ebola, and he dispatched Samantha Power to West Africa, both important symbolic gestures which may help curb fears long enough for a little science to sink in.  Or may not. Obama may not like the paranoid response to Ebola, he may even worry that measures like quarantines really will prove to be as counter-productive as the experts say, leading to a greater likelihood of Ebola cases in America, but he can’t be too upset. America’s power, not to mention minor details like its economy and foreign policy, is constructed upon a swirling foundation of irrational fear, not of a virus but of a bewildering series of bogeymen, from Communists to Muslims to terrorism to China.  (For further analysis, see Chapter 8 of David Keen’s excellent Useful Enemies).

Having a budgetary spend greater than the next ten nations combined is not easy to justify through rational political discourse, all the more so in a country (for example) whose infant mortality rate looks more like it belongs to Guinea.  The much-discussed military-industrial complex, firmly rooted in a hysterical reaction to foreign threats, remains impervious to the reality that the security measures of today manufacture ever greater threats in the future. Ditto for the potential of quarantines to increase the likelihood of Ebola cases on American soil.

5. The Secret of Economic Success

Question: What do Las Vegas, personal injury lawsuits, Lady Gaga and Ebola-induced panic all have in common? Answer: Nobody can beat the US when it comes to a penchant for excess.

No wonder West Africa is so poor. Not enough capacity for going OTT. The citizens of Guinea, Sierra Leone and Liberia watched neighbors and family drop dead around them, and yet still didn’t believe Ebola was real. A veritable ostrich head in the sand – never a good model for economic development. With one death to date and 45% of Americans worried a family member will catch Ebola, the greatest nation on Earth more resembles a frantic chicken. That’s the sort of mania needed for a juggernaut economy.

Critique of Aid, Health, Politics

Ebola: Three Ideas (continued)

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Ebola 3. A Time To Point Fingers? Yes.

“We can’t dawdle on this one”. That is Barack Obama on September 16, inaugurating a litany of Very Important People sounding clarion calls that the world must act to curtail the scourge of Ebola. David Cameron followed suit. Ban Ki Moon jumped up and down, calling for urgent action, also for nations to give lots of money to the UN and for Bono to organize some sort of Live Aid rerun. To date, the action of calling has greatly dwarfed the action of acting.

There is an undeniable truth to the urgent call for action. But having dawdled for so long – allowing this outbreak to infect and kill so many more people than should have been the case – there is a fundamental deceit in the call as well. In terms of preempting the exponential spread of this disease, the time to act passed four, five, maybe six months ago. Now we must talk of action – action on the ground in West Africa (not to be confused with airport screenings, conferences full of petits fours or throwing money at the problem) – and we must talk of accountability for its opposite.

Ellen Sirleaf Johnson in her recent letter to the world: It is time to stop talking and “send a message that we will not leave millions of West Africans to fend for themselves.” With all due respect, Madam President, that ship sailed. The nations of the world long ago decided that they would do exactly that. They decided to act only when it became a matter of self interest. And I note here that this self interest seems largely electoral, a question of curtailing political damage at home rather than a virus overseas.

Rather than save lives, the response of nations like the US or UK seems designed to save political ass. Through months of inaction, these governments are contributors to Ebola’s explosive spread. And yet they are the best the world has to offer right in terms of response.  We need their boots on ground.  The lone exception to self-interest seems to be Cuba, neither threatened by Ebola nor under pressure to respond, who has pledged hundreds of additional medical doctors on the ground.

Let me be very clear: the urgency of accountability exists because at the nation-state level this is not primarily a question of charity or even humanitarianism. This is not a question of choice or option. This is a question of human rights. This is a question of nations violating their obligation to provide international cooperation and assistance to Liberia, Sierra Leone and Guinea. See for example Physicians for Human Rights or Amnesty International. (Whose voices remain curiously muted. Where is a more strident defense of the human right to health? Where are creative R2P-inspired arguments that there is an international responsibility to protect citizens against a massive violation of their human rights when, as in West Africa, the states themselves are unable to do so?).

And then this is also a question of international security in the form of global outbreak response, which has been entrusted to the most powerful nations on Earth and the UN, who had the money, know-how and responsibility to act much earlier. Finally, there is the question of humanity. These nations, in pursuit of national interest and in a rather self-congratulatory fashion, do such a good job of talking the humanitarian talk; of talking the talk of caring and aiding and helping. But when it came to Ebola, they decided against doing the walk.

Another reason to act right now on accountability is to stop its perversion. We are in danger of accepting a simple story that the World Health Organization is to blame. Well, that is true. But there is a difference between blame for WHO shortcomings and exploiting the WHO as a scapegoat. For starters, there is the impact of WHO funding cuts by governments like Obama’s USA. Or even better, as Dr. Anne Sparrow writes in The Nation, world powers have ensured that the WHO has shifted emphasis to the diseases of the Western World. But more importantly, the WHO was only one of he firemen who sat and watched while this flame spread to a fire and then a blaze and then an outright conflagration.

Will heads roll in the governments of Guinea, Liberia and Sierra Leone? It is a simply wrong to believe that the “basketcase” state of their health systems were either natural or inevitable, like a typhoon. They should have been in a better position to deal with this outbreak. It is true that the scale of the outbreak today, or even back in July, would have swamped all but a well-developed nation. But we must assess matters earlier in time, when the basics of good case management and information flow could have prevented the outbreak from escaping control. What shocked me the most is that so many of their own citizens so distrusted these governments that Ebola was first seen as a ploy to attract and embezzle aid. The abundant health education message of EBOLA IS REAL makes me want to cry. How to stop an outbreak if that is where you begin?

And yet I heard Sirleaf Johnson blame the miserable state of her country’s healthcare system on a war that ended eleven years ago. Perhaps I missed her explanation of what happened to the considerable aid sent to Liberia to rebuild. Ditto for Sierra Leone or Guinea. As Human Rights Watch notes: Endemic corruption, including in health services, has long plagued the governments of all three countries and contributed to years of unrest and lack of development. It is in the first instance not the rich governments of the world who decided to leave millions of West Africans without adequate healthcare or basic outbreak response.

Governmental failure is a matter foremost for civil society. West African voices can already be heard. See, for example, this blog post, questioning poverty in the face of mineral riches and offering judgment on governance: It is not good enough for the Deputy Minister of Foreign Affairs of Sierra Leone Ebun Strasser – King to note that Ebola “took us by surprise and met us when we were ill prepared for it”. Or Abdul Tejan-Cole, speaking eloquently on seeing “civil society step up when government institutions have crumbled or not addressed the crisis”, not because of poverty but because of poor management.

Beyond governments, will heads roll in any aid NGO or agency aside from (presumably) WHO? What of those agencies who have spent years claiming to develop health capacity in West Africa? What of those who have raised money by declaring themselves leaders in global humanitarian emergency health? Where are their beds and nurses and doctors? And where were they when the epidemic could have been controlled? The WHO was silent and even downplayed the gravity of the situation. Did they own the only working phone in West Africa? Aside from MSF, where were the alarm bells from other agencies with health teams already on the ground? Are board members going to resign in disgust? Or is everybody too busy ramping up activities to respond to Ebola the cash cow in addition to Ebola the virus?

There are those who argue that now is the time for action, not recrimination. That is the pragmatic voice of the aid establishment. And that is sweet music for those responsible, who do not in any way fear the hand wringing and promises to do better in the future which have long served to excuse failure and defuse calls for change. To delay accountability now is to reinforce this entrenched pattern of inertia tomorrow.

As did the global political elite know and ignore brewing famine in south central Somalia a few years ago, as did they know and ignore the mounting crisis in Syria, so did they know and ignore the burgeoning Ebola crisis in Guinea, Liberia and Sierra Leone. This is the new world order, in which the most powerful are either unwilling to meet their international obligations, or incapable of doing what is right and what is human until direct self-interest and fear muster the political capacity to act.

Critique of Aid, Health, Our Western Identity

Ebola: Three Ideas You (hopefully) Haven’t Read

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[Originally posted September 26 and lost due to website issues. Apologies to those whose comments have been lost as well.]

Part 1. The Ebola crisis is in part the self-fulfilling prophesy of the way we think about Africa.

The Ebola crisis in Liberia, Sierra Leone and Guinea consumes no shortage of attention in mainstream Western media. Other African crises like CAR, Libya or Sudan, let alone success stories, should be so lucky. Then again, maybe attention isn’t such a good thing after all. Some of it quite responsible, much of it still trades in outworn stereotypes of a continent awash in warlords, loin cloths and killer microbes.

Hooray for resistance to sloppy Ebola storytelling, for example Dionne and Seay’s nailing Newsweek‘s sensationalist cover story. Or earlier this week Sierra Leonean Ishmael Beah skewering the way lopsided Ebola reporting reinforces the role of Africa as a foil, as a continent whose dismal failure reaffirms our superior Western civilization.

But why dump all the blame on the media? NGOs and the UN – the foreign aid establishment – surely merit some credit for perpetuating the popular notion that Africa is a cauldron of tribal brutality, a crucible of scary diseases and a reservoir of primitivism, all rolled into one waiting-for-a-savior basket. (Not to mention the rather stock idea that Africa is a country. On that geographical malapropism, see this great blog.). The point is firstly one of principle: NGOs should be truthful in their communications. Easier said than done. They appear locked into an audience (the home society public) that demands such a stereotype in order to feel compelled to donate (see e.g., my previous blog on this).

We’ve heard criticism of this stereotyping before, often from within the aid and Western media communities. Is there hope? Importantly, Beah published in the Washington Post, bringing his views to Western eyes. If only for a moment, his piece shakes our monopoly over the narrative. As I’ve written before, these stereotypes will come under increasing pressure as internet media expand access to Western debate and discussion. The question: Is the aid industry simply (!) a promoter of the distortion, or an addict as well? But that is for another blog.

The main point here is that the degree to which the monotonous, stereotyped portrayal of Africa gives rise to the conditions in which Ebola outbreaks occur. Persistent underdevelopment, bureaucratic inertia, low foreign investment, unresponsive government, the cycle of waiting for crisis rather than building systems, dependence on the foreign aid community, etc. These ills are all either caused and/or reinforced by the inaccurate portrait of a continent, in this latest episode with a virus as the star in a long line of unabated indigenous catastrophes. NGO action may be vital in combating Ebola, but aid agencies themselves helped weave the very “basketcase” to which they would nowadays respond.